Transcript Issues and Opportunities in the Organization and Financing

Issues and Opportunities in the
Organization and Financing of
Mental Health Services in School
Julia Graham Lear, Center for Health and
Health Care in Schools, The George
Washington University
MacArthur Foundation Mental Health
Network Meeting, Miami Beach, FL
December 6, 2001
Mental health services
in schools: an overview
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Lurking issues in school-based
mental health services
Current approaches to service
delivery
Organization-of-care issues
Financing challenges
Related activities
Possible directions for MacArthur
Network
Lurking issues in schoolbased mental health
services
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Population-targeted practice v.
individual-targeted practice?
What are the services to be
offered? Prevention? Screening?
Diagnosis? Short-term
interventions? Long-term services?
Whose goals? Is mental health
care in schools supporting an
education agenda or a health
agenda?
Current approaches to
service delivery
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School -system organized care
School-based health centers
School-based mental health
services
Organization-of-care
issues
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Who’s in charge?
Clinical practices: methods, quality
measurement, confidentiality,
parent consent
Staffing: credential and training
requirements, continuing
education, union issues
Financing challenges
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Multiple sources of funding: state grant
funds; Medicaid; managed care -- carve
outs, carve-ins, falling in-between; local
health and education budgets
Meeting requirements of funding agencies
Ability of provider organization to bill and
collect from 3rd party payers
Reluctance of primary care providers to
diagnose children with billable disorders
Thinking ahead:
Related activities
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The Survey of the Characteristics &
Financing of School Mental Health. Abt
Associates, SAMHSA funded.
Depression in Primary Care: Linking
Clinical & System Strategies. RWJF multisite grant program.
Caring for Kids: Expanding Mental &
Dental Health Services through SchoolBased Health Centers. RWJF multi-site
grant program
Possible directions
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Synthesis of post SGR work: at national,
state & local level
Research opportunities: content of schoolbased mental health care, patient care
outcomes
An invitational workshop for Mental Health
Commissioners, researchers & educators: to
discuss demonstrations & test political and
financial feasibility of expanding mental
health services in schools